Musings on Events in U.S. Immigration Court, Immigration Law, Sports, and Other Random Topics by Retired United States Immigration Judge (Arlington, Virginia) and former Chairman of the Board of Immigration Appeals Paul Wickham Schmidt. To see my complete professional bio, just click on the link below.

“First, health care: Here’s a giveway about how bad the new Senate health care bill is: Bill Cassidy, one of its authors, keeps trying to sell it by telling untruths.
“The relatively new phenomenon of just ‘up is down’ lying about your bill’s impacts is jarring,” says Loren Adler of the USC-Brookings-Schaeffer Initiative on Health Policy.Most egregiously, Cassidy is claiming that the bill would not ultimately deprive sick people of health insurance. That’s false, as NPR calmly explained when Cassidy said otherwise.
In fact, the bill — known as Graham-Cassidy — would free states to remove insurance protections for people with pre-existing conditions. Without those protections, insurers could price such people out of the market.
If you get cancer (or even have a family history of it) or your child is born with a birth defect — among many, many other health issues — you could find yourself unable to buy insurance. Without insurance, you could be denied crucial treatments. In a tangible way, Graham-Cassidy would harm millions of Americans.
Aviva Aron-Dine and Sarah Kliff have both written good explainers on this issue. As Kliff notes, “There is literally no analysis” to support Cassidy’s claim that the bill would expand the number of insured.
Jimmy Kimmel, the country’s most unexpected health wonk, has urged Cassidy to stop “jamming this horrible bill down our throats.”
Insurers came out against the bill yesterday, joining doctors, hospitals, AARP, patient advocates, multiple governors and others.
Meanwhile, Republican leaders are trying to win the vote of Lisa Murkowski — one of three Republican senators who voted against a previous Obamacare repeal bill, in July — by funneling money to Alaska.
In the least surprising development of all, President Trump is now repeating Cassidy’s falsehoods.
The last word on health care this morning goes to Nicholas Bagley of the University of Michigan. “Graham-Cassidy is a brazen effort to block any level of government, state or federal, from achieving near-universal coverage,” he writes. “That’s what the debate is about. Everything else is just noise.”

Read Leonhardt’s entire piece with working links to his sources and citations at this link:

And Leonhardt is by no means the only one blowing the whistle on the GOP’s latest War on America. Among many others, the Washington Post’s “Fact Checker” awarded Senator Cassidy “Three Pinocchios” for his false claims about coverage:

“Regular readers of The Fact Checker know that the burden of proof falls on the person making the claim. Cassidy has provided little evidence to support his claim of more coverage, except that innovation would flourish and help bring down costs and expand coverage. That’s certainly possible, but it would be more plausible if his proposal did not slash funding to such an extent.

Kimmel’s claim that 30 million fewer Americans will have insurance may be a high-end estimate. But already, in 2019, CBO calculations suggest at least 15 million fewer Americans would have insurance once the individual and employer mandates are repealed. Much of that decline might be by choice, but Cassidy insists the gap will be filled and then exceeded in 10 years. Unlike Cassidy, no prominent health-care analyst is willing to venture a guess on coverage levels — but the consensus is that his funding formula makes his claim all but impossible to achieve.

Given the lack of coverage estimates by the CBO or other health-care experts, Cassidy’s claim does not quite rise to Four Pinocchios. But it certainly merits a Three.

“Sen. Bill Cassidy (R-La.) is pushing a health-care bill that could get a Senate vote in the next two weeks.
A dealbreaker in July may not be a dealbreaker in September.

The latest Obamacare overhaul bill gaining steam on Capitol Hill slashes health-care spending more deeply and would likely cover fewer people than a July bill that failed precisely because of such concerns. What’s different now is the sense of urgency senators are bringing to their effort to roll back the Affordable Care Act, with only a dozen days remaining before the legislative vehicle they’re using expires.

The political prospects for the bill, offered by Sens. Bill Cassidy (R-La.) and Lindsey O. Graham (R-S.C.), seemed to be improving by the hour Monday. A key Republican governor, Arizona’s Doug Ducey, signaled support for the legislation, and some moderate senators whose votes are crucial have either signed onto the bill or at least haven’t ruled it out yet. Ducey opposed the Senate leadership’s Better Care Reconciliation Act — which was defeated in July — and his opposition heavily influenced the decision by Sen. John McCain (R-Ariz.) not to back that measure.

Worries over steep Medicaid cuts and how many people could potentially lose protections or their health coverage altogether drove the GOP effort into a ditch at the end of July, when BCRA failed by seven votes.

It’s hard to see how the Cassidy-Graham plan resolves those concerns. In many cases, it could make them even more acute. The Congressional Budget Office has said it will release a “preliminary assessment” of the measure next week, which will provide some information on its effects on the budget. But the CBO said it would be “at least several weeks” before it can estimate whether people would lose insurance and whether premiums would spike.

The measure would actually cut federal health-care spending even more than BCRA, and aim the cuts more directly at states that expanded Medicaid under the Affordable Care Act. It was the governors and senators from those states who were most deeply worried about Medicaid cuts to begin with.”

*********************************

The GOP is a threat to the health, safety, and welfare of most Americans. When will voters wake up and vote these clowns out of office before they do irreparable damage to America?

President Trump’s recent call for overhauling the legal immigration system suffers from serious racial implications and violations of basic family values. Earlier this month he endorsed the Reforming American Immigration for a Strong Economy (RAISE) Act, which would eliminate all family reunification categories beyond spouses and minor children of U.S. citizens and lawful permanent residents (reducing the age limit for minor children from 21 to 18), and would lower capped family categories from 226,000 green cards presently to 88,000. The prime relatives targeted for elimination are siblings of U.S. citizens and adult children of citizens and lawful residents. The diversity immigration lottery program, which grants 50,000 green cards to immigrants from low-admission countries, also would be terminated. The RAISE Act is essentially the Asian, Latino, and African Exclusion Act of 2017. Why? Because the biggest users of family immigration categories are Asians and Latinos, and the biggest beneficiaries of the diversity lottery are Africans.

The RAISE Act is an elitist point system that favors those with post-secondary STEM degrees (science, technology, engineering, or mathematics), extraordinary achievement (Nobel laureates and Olympic medalists), $1.35 to $1.8 million to invest, and high English proficiency. However, it fails to connect prospective immigrants with job openings and makes incorrect assumptions about family immigrants.

Promoting family reunification has been a major feature of immigration policy for decades. Prior to 1965, permitting spouses of U.S. citizens, relatives of lawful permanent residents, and even siblings of U.S. citizens to immigrate were important aspects of the immigration selection system. Since the 1965 reforms, family reunification has been the major cornerstone of the immigration admission system. Those reforms, extended in 1976, allowed twenty thousand immigrant visas for every country. Of the worldwide numerical limits, about 80 percent were specified for “preference” relatives of citizens and lawful permanent residents, and an unlimited number was available to immediate relatives of U.S. citizens. The unlimited immediate relative category included spouses, parents of adult citizens, and minor, unmarried children of citizens. The family preference categories were established for adult, unmarried sons and daughters of citizens, spouses and unmarried children of lawful permanent resident aliens, married children of citizens, and siblings of citizens. Two other preferences (expanded in 1990) were established for employment-based immigration.

Asian and Latino immigration came to dominate these immigration categories. The nations with large numbers of descendants in the United States in 1965, i.e., western Europe, were expected to benefit the most from a kinship-based system. But gradually, by using the family categories and the labor employment route, Asians built a family base from which to use the kinship categories more and more. By the late 1980s, virtually 90 percent of all immigration to the United States – including Asian immigration – was through the kinship categories. And by the 1990s, the vast majority of these immigrants were from Asia and Latin America. The top countries of origin of authorized immigrants to the United States today include Mexico, China, India, the Philippines, the Dominican Republic, Vietnam, and El Salvador.

As Asian and Latin immigrants began to dominate the family-based immigration system in the 1970s and 1980s, somehow the preference for family reunification made less sense to some policymakers. Since the early 1980s, attacking kinship categories – especially the sibling category – has become a political sport played every few years. Often the complaint is based on arguments such as we should be bringing in skilled immigrants, a point system would be better, and in the case of the sibling category, brothers and sisters are not part of the “nuclear” family. Proposals to eliminate or reduce family immigration were led by Senator Alan Simpson throughout the 1980s, Congressman Bruce Morrison in 1990, and Senator Simpson and Congressman Lamar Smith in 1996. As prelude to the RAISE Act, the Senate actually passed S.744 in 2013 that would have eliminated family categories and installed a point system in exchange for a legalization program for undocumented immigrants.

Pitting so-called “merit-based” visas in opposition to family visas implies that family immigration represents the soft side of immigration while point-based immigration is more about being tough and strategic. The wrongheadedness of that suggestion is that family immigration has served our country well even from a purely economic perspective. The country needs workers with all levels of skill, and family immigration provides many of the needed workers.

A concern that the current system raises for some policymakers is based on their belief that the vast majority of immigrants who enter in kinship categories are working class or low-skilled. They wonder whether this is good for the country. Interestingly enough, many immigrants who enter in the sibling category actually are highly skilled. The vast majority of family immigrants are working age, who arrive anxious to work and ready to put their time and sweat into the job. But beyond that oversight by the complainants, what we know about the country and its general need for workers in the short and long terms is instructive.

The Wharton School of Business projects that the RAISE Act would actually lead to less economic growth and fewer jobs. Job losses would emerge because domestic workers will not fill all the jobs that current types of immigrant workers would have filled. In the long run, per capita GDP would dip. Furthermore, in the Bureau of Labor Statistics’s forecast of large-growth occupations, most jobs require only short- or moderate-term on-the-job training, suggesting lower skilled immigrants could contribute to meeting the demand for these types of jobs.

The economic data on today’s kinship immigrants are favorable for the country. The entry of low-skilled as well as high-skilled immigrants leads to faster economic growth by increasing the size of the market, thereby boosting productivity, investment, and technological practice. Technological advances are made by many immigrants who are neither well-educated nor well-paid. Moreover, many kinship-based immigrants open new businesses that employ natives as well as other immigrants; this is important because small businesses are now the most important source of new jobs in the United States. The current family-centered system results in designers, business leaders, investors, and Silicon Valley–type engineers. And much of the flexibility available to American entrepreneurs in experimenting with risky labor-intensive business ventures is afforded by the presence of low-wage immigrant workers. In short, kinship immigrants contribute greatly to this country’s vitality and growth, beyond the psychological benefits to family members who are able to reunite.

The preamble to the Universal Declaration of Human Rights highlights the unity of the family as the “foundation of freedom, justice and peace in the world” for good reason. Our families make us whole. Our families define us as human beings. Our families are at the center of our most treasured values. Our families make the nation strong.

Bill Ong Hing is the Founder and General Counsel of the Immigrant Legal Resource Center, and Professor of Law and Migration Studies, University of San Francisco”

********************************************************************

Unhappily, America has a sad history of using bogus arguments about the economy and protecting American labor to justify racist immigration acts. Among other things, the Chinese Exclusion Act was supposed to protect the U.S. against the adverse effects of “coolie labor.”

I find it remarkable that those pushing the RASE Act are so ready to damage American families, the fabric of our society, and our economy in a futile attempt to achieve their White Nationalist vision.

“Under the plan — if approved by Congress, which will be a heavy lift — the highest point-getting candidate, for example, not including special circumstances, would be a 26- to 31-year-old with a US-based doctorate or professional degree, who speaks nearly perfect English and who has a salary offer that’s three times as high as the median income where they are.

Have an Olympic medal or Nobel Prize? That will help too.

A candidate must have at least 30 points to apply.

Here’s how the points would be doled out:

Age

Priority is given to prime working ages. Someone aged 18 through 21 gets six points, ages 22 through 25 gets eight points and ages 26 through 30 get 10 points.

The points then decrease, with someone aged 31 through 35 getting eight points, 36 through 40 getting six points, ages 41 through 45 getting four points and ages 46 through 50 getting two points.

Minors under the age of 18 and those over the age of 50 receive no points, though people over 50 years old are still allowed to apply.”

“Trump’s appearance with the senators came as the White House moved to elevate immigration back to the political forefront after the president suffered a major defeat when the Senate narrowly rejected his push to repeal the Affordable Care Act. The president made a speech last Friday on Long Island in which he pushed Congress to devote more resources to fighting illegal immigration, including transnational gangs.

The event on Wednesday illustrated the president’s efforts to broaden his push to reform border control laws beyond illegal immigration. Trump called the changes to legal immigration necessary to protect American workers, including racial minorities, from rising competition for lower-paid jobs.

“Among those who have been hit hardest in recent years are immigrants and minority workers competing for jobs against brand new arrivals,” Trump said. “It has not been fair to our people, our citizens and our workers.”

But the bill’s prospects are dim in the Senate, where Republicans hold a narrow majority and would have difficulty getting 60 votes to prevent a filibuster. The legislation is expected to face fierce resistance from congressional Democrats and immigrant rights groups and opposition from business leaders and some moderate Republicans in states with large immigrant populations.

Opponents of slashing immigration levels said immigrants help boost the economy and that studies have shown they commit crimes at lower levels than do native-born Americans.

“This is just a fundamental restructuring of our immigration system which has huge implications for the future,” said Kevin Appleby, the senior director of international migration policy for the Center for Migration Studies. “This is part of a broader strategy by this administration to rid the country of low-skilled immigrants they don’t favor in favor of immigrants in their image.”

Other critics said the Raise Act, which maintains the annual cap for employment-based green cards at the current level of 140,000, would not increase skilled immigration and could make it more difficult for employers to hire the workers they need. And they noted that Canada and Australia admit more than twice the number of immigrants to their countries as the United States does currently when judged as a percentage of their overall population levels.

“Just because you have a PhD doesn’t mean you’re necessarily more valuable to the U.S. economy,” said Stuart Anderson, executive director of the National Foundation for American Policy. “The best indication of whether a person is employable is if someone wants to hire them.”

Alex Nowrasteh, an immigration policy analyst at the CATO Institute, wrote in a blog that the bill “would do nothing to boost skilled immigration and it will only increase the proportion of employment-based green cards by cutting other green cards. Saying otherwise is grossly deceptive marketing.”

Groups that favor stricter immigration policies hailed the legislation as a step in the right direction. Roy Beck, president of NumbersUSA, said the Raise Act “will do more than any other action to fulfill President Trump’s promises as a candidate to create an immigration system that puts the interests of American workers first.”

*****************************************************

If Stephen Miller and Roy Beck favor it, you can be sure that it’s part of a racist agenda.

“Senate Republicans suffered a dramatic failure early Friday in their bid to advance a scaled-back plan to overhaul the Affordable Care Act, throwing into question whether they can actually repeal the 2010 health law.

Their latest effort to redraw the ACA failed after Sen. John McCain’s decision to side with two other Republicans against President Trump and GOP leaders. The Arizona Republican, diagnosed with brain cancer last week, returned to Washington on Tuesday and delivered a stirring address calling for a bipartisan approach to overhauling the ACA, while criticizing the process that produced the current legislation.

It was a speech that laid the groundwork for Friday’s dramatic vote.

The vote was 49 to 51 — all 48 members of the Democratic caucus joined with McCain and Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska) to block the legislation.”

*********************************

“Republican female senators whose disapproval of the GOP health-care effort has at times endangered its progress are facing an increasingly pointed backlash from men in their party, including a handful of comments that invoked physical retaliation.

In the past week, Sen. Susan Collins (Maine) has been challenged by a male lawmaker to a duel. She and Sen. Lisa Murkowski (Alaska) were told that they and others deserve a physical reprimand for their decisions not to support Republican health-care proposals. Murkowski, who voted with Collins against starting the health-care debate this week, was specifically called out by President Trump on Twitter and told by a Cabinet official that Alaska could suffer for her choice, according to a colleague.

The language of retribution increasingly adopted by Republican men reflects Trump’s influence and underscores the challenges GOP women can face when opposing the consensus of their party, which remains dominated by men, outside experts said. A videotape of Trump surfaced during the campaign revealing him bragging in vulgar terms about groping women, and some believed that opened the gates for further insults and degrading behavior toward women.

“Masculine dominance in the Republican Party is not only in numbers but in culture,” said Kelly Dittmar, a scholar at the Center for American Women and Politics at Rutgers University and the author of “Navigating Gendered Terrain: Stereotypes and Strategy in Political Campaigns.”

“When the person who is supposed to be the leader of the party shows it’s okay to use those sorts of attacks, whether they are specifically gendered or not, that is something that catches on at other levels,” Dittmar said. “We see it in the [elected officials] who feel it’s okay to say things like this.”

****************************************************

Gee, are there only three adults in the “romper room” that passes for the Senate GOP? According to NBC’s Chuck Todd on Today, at least a dozen GOP Senators were “secretly relieved” that McCain vetoed the bill. What happened to their backbones? Whatever happened to governing for the good of the country, rather than trying to make good on boneheaded campaign promises? How much taxpayer money has the GOP wasted with its endless bogus votes to repeal Obamacare and the ongoing legislative circus they have been staging? Probably enough to pay for health care in all the rural counties in America.

Oh, and the threats to let Obamacare tank (that’s the latest version of Trump(we don’t)care)? Those hurt most would be the poor and struggling folks out there in Trumpland. Interesting that Democrats were willing to stand up for them, even though the folks in Trumpland were not willing to stand up for the rest of us Americans. Yeah, and no amount of Kris Kobach, Mike Pence obfuscation and outright lying can change the fact that the majority of Americans voted against the Trump Circus in the first place.

I’ve read lots of articles about how the rest of us need to be kind, compassionate, and understanding of the needs and situations of those who voted for Trump. Generally, I agree with that. It’s one country, and we should take care of everyone, including those who have differing ideas and those who can’t take care of themselves. But, as the GOP would say, at some point there has to be at least a little sense of personal responsibility. Don’t the folks who irresponsibly voted for a supremely (and obviously) unqualified individual to occupy the highest office in the land, and compounded the problem by putting a party that can’t (and never really has been) able to govern in power, bear any accountability for the disaster that has followed?

And one more thing. Could we please have a moratorium on articles about the “legislative genius” of Mitch McConnell?

NQRFPT = Not Quite Ready For Prime Time

“The inability of a Republican Congress and a Republican president to repeal Obamacare, or even just dial it back, is yet the latest demonstration that Republicans simply aren’t ready to govern.

The facile explanation for this is the unresolved division, within the party, between its radical tea party populist wing and its more moderate, business-friendly establishment wing. But the bigger issue is that the party’s elected politicians are unwilling to make the trade-offs that are the essence of what governing is about.

On health care, for example, they promised to lower premiums but refused to embrace any of the three approaches that could accomplish that: increase co-payments and deductibles; squeeze the incomes of doctors, hospitals and drug companies; or finance more of the country’s health care through higher taxes.

. . . .

As a group, they have demonstrated a breathtaking lack of policy knowledge and sophistication, a stubborn disregard for intellectual honesty, lousy political instincts and a broken moral compass. Their leaders have forgotten what it means to lead, if they ever knew, while their backbenchers don’t have a clue of what it takes to be constructive followers. If there were a bankruptcy code for politics, it’s safe to say the Republicans would be in Chapter 11.

This complete abdication of governing responsibility was confirmed Tuesday when the party’s nominal leader, President Trump, announced to the country, “I think we are probably in that position where we will just let Obamacare fail. … I can tell you the Republicans are not going to own it.”

Even Sen. Shelly Caputo, the reliably party-line toting Republican from West Virginia, was moved to distance herself from that cynical win-at-any-cost strategy. “I did not come to Washington to hurt people,” she said.

“It’s almost an embarrassment being an American citizen traveling around the world … listening to the stupid s‑‑‑ we have to deal with in this country,” Jamie Dimon, the chairman of JPMorgan Chase, said in an unguarded moment last week. Dimon was quick to add, reflexively, that it wasn’t a Republican or a Democratic issue, but he knows better than that. Republicans were handed a golden opportunity to govern and they have blown it. This one is on them.”

**********************************************

At the link, read Pearlstein’s complete op-ed which contains many great examples of how the GOP fails to “do the right thing” over and over. And, he only touches on the “gonzoness,” moral vapidness, and complete disregard for sound government and prudent expenditure of public funds demonstrated by Trump’s immigration policies.

“Republicans should just REPEAL failing Obamacare now & work on a new Healthcare Plan that will start from a clean slate,” the president tweeted, adding that “Dems will join in!”

The “clean repeal” option is unpopular in both parties, and it’s unclear how much support the president’s proposal will garner in Congress. It would take 60 votes in the Senate for an outright repeal of the Affordable Care Act, and Republicans only hold a 52-seat majority.

Trump’s response came after Sens. Jerry Moran (R-Kan.) and Mike Lee (R-Utah) announced Monday evening that they planned to vote no on a “motion to proceed” for the Senate’s legislation ― a step needed to begin debate on the bill.”

*******************************************

Duh, after being treated with total disrespect and contempt by the President and the GOP for 6 months, why is it that Democrats would suddenly jump at the chance to pull the Administration’s chestnuts out of the fire?

On the other hand, a nuanced “fix” of Obamacare probably would have had enough votes to pass both Houses with bipartisan support from all or most Democrats and enough Republicans. But, that wouldn’t have allowed the GOP and Trump to have claimed “victory” on an Obamacare repeal. Talk about a President and a party who have long ago abandoned the best interests of America!

And, just think about all the time and taxpayer money the GOP has wasted over the past few years passing boneheaded, cosmetic “Obamacare repeals.” Obviously, the folks who voted for such nonsense were posturing rather than legislating.

“Being uninsured can be lethal,” review author Steffie Woolhandler of City University of New York told BuzzFeed News.

Congress is in the middle of efforts to pass a Republican health care plan. The House has already passed its own version of health care legislation, while the Senate released its own draft Senate bill last week and unveiled an updated version earlier today. The Congressional Budget Office released an analysis late Monday finding the Senate bill would save $321 billion over the next decade at a cost of 22 million more uninsured people than under Obamacare by 2026.

“A little negotiation, but it’s going to be very good,” President Trump said of the bill on Thursday, when it was first unveiled.

Whether removing all those people from medical coverage, and cutting their access to preventive care for diseases such as diabetes, high blood pressure or cancer, would actually lead to more deaths has emerged as a point of contention in debate over repealing Obamacare, which has enrolled about 20 million people in health insurance and Medicaid plans since 2010.

In reality, people without health insurance face odds ranging from 3% to 29% higher of dying prematurely compared to someone who has health insurance, concludes the Annals Of Internal Medicine review. Taking the midpoint of those odds as a benchmark, Woolhandler suggested that about 1,300 people a year die prematurely every year in the US for every one million people who lose health insurance.

Obamacare, which added about 20 million people to the ranks of the insured, likely preserved lives at that same rate, she said.

. . . . .

Worth noting, the American College of Physicians, which publishes the journal that released the review, has opposed Republican efforts to repeal Obamacare, joining the American Medical Association and the National Association of Medicaid Directors, among medical groups criticizing the Senate’s draft bill. Woolhandler and Himmelstein served as unpaid advisors to Sen. Bernie Sanders’ presidential campaign and founded a doctor’s organization that advocates for universal health care.”

******************************************************

Meanwhile, back at the ranch, the CBO predicts that an additional 22 million individuals would lose coverage under the GOP’s Senate Bill:

“Senate Republicans’ bill to erase major parts of the Affordable Care Act would cause an estimated 22 million more Americans to be uninsured in the coming decade — roughly a million fewer than similar legislation recently passed by the House, according to the Congressional Budget Office.

The forecast issued Monday by Congress’s nonpartisan budget scorekeepers also estimates that the Senate measure, drafted in secret mainly by Majority Leader Mitch McConnell and aides, would reduce federal spending by $321 billion by 2026 — compared with $119 billion for the House’s version.

The CBO’s analysis has been awaited as a crucial piece of evidence as McConnell (Ky.) and other Republican leaders try to hurry a vote on the bill this week. But they are navigating an expanding minefield of resistance from their own party’s moderate and conservative wings, while Democrats are united against it.

The additional deficit savings gives those leaders plenty of room to add more spending to win votes from skeptical moderate Republicans like Sens. Dean Heller (Nev.), Rob Portman (Ohio) and Bill Cassidy (La.), who want more money and a dedicated fund to help treat opioid abuse. Senate budget rules require that the final legislation save at least $133 billion, more than was saved in the House bill, giving senators $188 billion to make the bill more palatable.

Any extra spending risks alienating conservatives, however, and could threaten a delicate balance McConnell must strike to win votes from at least 50 of the 52 Senate Republicans. And some moderates have said they will decide whether they can support the Better Care Reconciliation Act based on how it will affect Americans who have gained coverage under the ACA during the past few years.”

When the Grim Reaper shows up, a GOP party card and a Trump “Make America Great” hat won’t do any good. You’ll have to go so that Trump, McConnell, Ryan, and their “fat cat” buddies can live “higher on the hog.”

“Senate Republican leaders unveiled their health-care bill Thursday morning, after weeks of crafting it behind closed doors. The bill keeps some popular parts of the Affordable Care Act, such as the provision preventing insurance companies from charging people more or denying them coverage based on pre-existing conditions, and eliminates some unpopular parts, such as the individual mandate which requires people to buy insurance or pay a penalty.

[What the Senate bill changes about Obamacare]

But those two provisions, taken together, are likely to send the individual marketplace into a “death spiral,” ending with only the sickest people insured, sky-high premiums, and insurers exiting the individual market, according to experts across the political spectrum. The bill has a $112 billion market stabilization fund to prevent this, but experts doubt it, or a similar measure in the House bill, would be enough.

Here’s how a death spiral would happen. People shopping for insurance in the individual market all sit on a spectrum from healthy to sick.”

*************************************************

Lots of “neat” graphics with the full article. Clink the link and see the GOP’s plan to “deconstruct” American healthcare in action.

Sobering thought: Millions of Americans voted to destroy their own healthcare and endanger their own lives and those of family members who can’t vote. Unfortunately, their lack of prudence and sound judgment is likely to take the rest of us into the abyss with them. The “silver lining:” Guys like the Koch Bros, Tom Price, Wilber Ross, et. al. will pay lower taxes. (I didn’t include Trump in this list because there is no hard evidence that he currently pays, or ever again will pay, income taxes.)

“The “health-care bill” that Republicans are trying to pass in the Senate, like the one approved by the GOP majority in the House, isn’t really about health care at all. It’s the first step in a massive redistribution of wealth from struggling wage-earners to the rich — a theft of historic proportions.

Is the Senate version less “mean” than the House bill, to use President Trump’s description of that earlier effort? Not really. Does the new bill have the “heart” that Trump demanded? No, it doesn’t. The devil is not in the details, it’s in the big picture.

Fundamentally, what Republicans in both chambers want to do is cut nearly $1 trillion over the next decade from the Medicaid program, which serves almost 70 million people. Medicaid provides health care not just for the indigent and disabled but also for the working poor — low-wage employees who cannot afford health insurance, even the plans offered through their jobs.

Additionally, about 20 percent of Medicaid spending goes to provide nursing home care, including for middle-class seniors whose savings have been exhausted — a situation almost any of us might confront. Roughly two-thirds of those in nursing homes have their care paid by Medicaid.

Why would Republicans want to slash this vital program so severely? You will hear a lot of self-righteous huffing and puffing about the need for entitlement reform, but the GOP’s intention is not to use the savings to pay down the national debt. Instead, slashing Medicaid spending creates fiscal headroom for what is euphemistically being called “tax reform” — a soon-to-come package of huge tax cuts favoring the wealthy.

That’s the basic equation in both the House and Senate bills: Medicaid for tax cuts. Both bills start with various of the taxes imposed by the Affordable Care Act, but those are mere appetizers. The main course is intended to be big cuts in individual and corporate tax rates that would benefit the rich.

There is no other point to this whole exercise. All the “Obamacare is in a death spiral” talk is Republican wishful thinking, aided and abetted by active sabotage.”

****************************************

Undoubtedly, many of those who would die or suffer needlessly as a result of the GOPs “Reverse Robin Hood” operation would be Democrats and non-voters (like children). But, many in the GOP base also fall within the group of poor and “lower middle class” folks who would be sentenced to death or suffering by the GOP. Killing off your own voters, with their support, is an interesting new twist in modern GOP politics. But, obviously Trump, McConnell, Ryan, and their Fat Cat handlers are confident in the gullibility and inability of many in their base to discern either their own or the general public’s best interests. Difficult to comprehend.

“It is difficult to overstate the sheer unpopularity of the American Health Care Act, the Republican Party’s plan to “repeal and replace” the Affordable Care Act. And it’s not hard to understand why the bill is so unpopular. What’s mystifying is why Republicans insist on passing it, acting as if there won’t be political consequences for a plan that promises pain for tens of millions of Americans.

JAMELLE BOUIE

Jamelle Bouie is Slate’s chief political correspondent.

At Obamacare’s least popular moment, in the fall of 2014, 56 percent of Americans held a negative view of the law, versus 37 percent who approved. Compare that with the Republican version of the AHCA that passed the House of Representatives in early May. In a recent survey from CBS News, 59 percent of Americans disapprove of the GOP proposal, versus 32 percent who approve. A Roper Center analysis shows the proposal with just 29 percent support, making it the most unpopular piece of legislation Congress has considered in decades. And its unpopularity isn’t just a function of blue states like California, New York, and Illinois—there is no state in the union where a majority of voters support the bill.

If the AHCA ends up improving outcomes for Americans—if it delivers affordable health insurance or protects families from medical bankruptcy—it might recover some popularity in the implementation, as was true with the Affordable Care Act, which now has majority support. But we know from the Congressional Budget Office’s evaluation of the House bill that it would increase the number of uninsured by an estimated 23 million people; there are no signs the Senate version will be any less damaging. What’s more, the AHCA may upend the employer health market as well; its deregulatory measures could result in lifetime limits and substantially higher out-of-pocket costs for people who receive insurance through work. The universe of people potentially left worse off by the Republican bill is close to a cross-section of the American public: salaried employees, ordinary workers who rely on the Obamacare exchanges, and the millions of low-income people, children, elderly, and disabled Americans who rely on Medicaid.

Under most circumstances, this would be the ballgame. As a general matter, lawmakers don’t pass hugely unpopular legislation that might harm constituents in such a direct way. It’s easy to say that, for House and Senate Republicans, their “constituents” are those wealthy Americans who receive huge tax cuts under the bill. Still, it’s also true that winning donors isn’t the same as winning elections. Politicians don’t need to value the public interest to reject a bill like the AHCA; a survival instinct should be enough.

Which gets to what’s mystifying about the present situation. If the health care bill becomes law, there’s every indication the Republican Party will suffer for passing it. It is already responsible for a substantial and so-far enduring decline in the president’s approval rating, and it is fueling grass-roots opposition to the already-unpopular Trump administration. If Republicans face an increasingly difficult environment for the 2018 general election, it is at least in part because of the AHCA. And yet, Republicans are intent on passing the bill. Senate Majority Leader Mitch McConnell has cannily adopted an unprecedentedlysecretive process meant to insulate the proposal from criticism and expedite its passage. There have been no hearings and no debate. The plan, as it exists, is for a one-week period of public input before Congress votes.

It is policy without any actual policy.

It’s likely that Republicans know the bill is unpopular and are doing everything they can to keep the public from seeing its contents before passing it. As we saw with the Affordable Care Act, the longer the process, the greater the odds for a major backlash. But this presupposes a pressing need to pass the American Health Care Act, which isn’t the case, outside of a “need” to slash Medicaid, thus paving the way for large-scale, permanent tax cuts. The Republican health care bill doesn’t solve any urgent problem in the health care market, nor does it represent any coherent vision for the health care system; it is a hodgepodge of cuts and compromises, designed to pass a GOP Congress more than anything. It is policy without any actual policy. At most, it exists to fulfill a promise to “repeal Obamacare” and cut taxes.

Perhaps that’s enough to explain the zeal to pass the bill. Republicans made a promise, and there are forces within the party—from hyperideological lawmakers and conservative activists to right-wing media and Republican base voters—pushing them toward this conclusion. When coupled with the broad Republican hostility to downward redistribution and the similarly broad commitment to tax cuts, it makes sense that the GOP would continue to pursue this bill despite the likely consequences.

But ultimately it’s not clear the party believes it would face those consequences. The 2018 House map still favors Republicans, and the party is defending far fewer Senate seats than Democrats. Aggressively gerrymandered districts provide another layer of defense, as does voter suppression, and the avalanche of spending from outside groups. Americans might be hurt and outraged by the effects of the AHCA, but those barriers blunt the electoral impact.

The grounds for political combat seem to have changed as well. If recent special elections are any indication—where GOP candidates refused to comment on signature GOP policies—extreme polarization means Republicans can mobilize supporters without being forced to talk about or account for their actual actions. Identity, for many voters, matters more than their pocketbooks. Republicans simply need to signal their disdain—even hatred—for their opponents, political or otherwise. Why worry about the consequences of your policies when you can preclude defeat by changing the ground rules of elections, spending vast sums, and stoking cultural resentment?

It seems, then, that we have an answer for Republicans insist on moving forward with the American Health Care Act. Because they can. And who is going to stop them?”

Here’s some analysis of the GOP Senate Bill from the Washington Post:

“The Senate proposal largely mirrors the House measure with significant differences, according to a discussion draft circulating Wednesday among aides and lobbyists. While the House legislation would peg federal insurance subsidies to age, the Senate bill would link them to income, as the ACA does.

The Senate measure would cut off expanded Medicaid funding for states more gradually than the House bill but would enact deeper long-term cuts to the health-care program for low-income Americans. It also would eliminate House language aimed at prohibiting federally subsidized health plans from covering abortions, a provision that may run afoul of complex Senate budget rules.

But McConnell faces the prospect of an open revolt from key conservative and moderate GOP senators, whose concerns he has struggled to balance in recent weeks. Republicans familiar with the effort said Senate leaders have more work to do to secure the 50 votes needed to pass the measure, with Vice President Pence set to cast the tiebreaking vote, from the pool of 52 GOP senators. No Democrats are expected to support the bill.

According to two Republicans in close contact with Senate GOP leadership granted anonymity to describe private conversations, McConnell is threatening to bring the bill to a vote next week even if he doesn’t have the votes to pass it. But some believe that message is aimed at trying to pressure Republicans to support the bill, rather than an absolute commitment. A McConnell spokeswoman declined to comment.

Republican aides stressed that their plan is likely to undergo more changes to secure the votes needed for passage, but there were major concerns Wednesday from senators on opposite ends of the GOP spectrum.

“My main concern is I promised voters that I would repeal — vote to repeal Obamacare. And everything I hear sounds like Obamacare-lite,” said Sen. Rand Paul (R-Ky.).

Sen. Shelley Moore Capito (R-W.Va.), whose state expanded Medicaid and has been pushing for a more gradual unwinding of that initiative than many conservatives prefer, said she is waiting to scrutinize what is released but has not seen anything yet that would make her drop her concerns with the proposal.

“Up to this point, I don’t have any new news — tomorrow we will see it definitively — that would cause me to change that sentiment,” she said.

Like the House bill, the Senate measure is expected to make big changes to Medicaid, the program that insures about 74 million elderly and lower-income Americans and was expanded in most states under the ACA. In effect, the revisions would reduce federal spending on the program.

The Senate measure would transform Medicaid from an open-ended entitlement to one in which federal funding would be distributed to states on a per capita basis. The Senate measure would also seek to phase out the program’s expansion — although at a more gradual rate than the House version.

Yet the Senate bill would go further than the House version in its approach to cutting Medicaid funding in the future. In 2025, the measure would tie federal spending on the program to an even slower growth index than the one used in the House bill. That move could prompt states to reduce the size of their Medicaid programs.”

As long as folks stubbornly keep voting for their own demise, that is, against their own best interests, Trump and the GOP are going to take them to the cleaners every time. The GOP Congressional leadership has “bought into” the Trump “Time Square” theory: “There’s absolutely nothing that we could do that would make these folks vote against us. And, we’re going to take full advantage of them by sticking it to them just like they were Democrats or minorities (or both).”

I suppose if it works, why not line your pockets (and those of your buddies) to the full extent possible at the expense of the People until the party ends (which it might never do — and, if it does, the GOP will be laughing all the way to the bank)?

“David Leonhardt
Op-Ed Columnist
The Congressional Budget Office’s analysis of the House health care bill is a devastating indictment.
The report, released yesterday, showed that millions of Americans would lose health insurance and the quality of insurance for millions more would deteriorate. The savings from that carnage — to borrow a favorite word of President Trump’s — would pay for tax cuts for the wealthy.
And yet the immediate reaction to the C.B.O. report also shows why you should be worried that the Senate will nonetheless decide to pass a version of the House bill.
Here’s what I mean: Much of this initial reaction has missed the point. It has focused on the modest differences between the new C.B.O. report, which analyzed the final House bill, and a C.B.O. analysis from March of an earlier version of the bill. Among the differences, the final bill would deprive an estimated 23 million people of insurance, compared with the 24 million in the March analysis.
Don’t be distracted by these small differences.
Distraction is a tactic of the politicians who are trying to take away health insurance from people. These politicians can’t sell their proposals on the merits. That’s why both the House and, thus far, the Senate have refused to hold any hearings. They know that virtually every expert across the ideological spectrum — including groups representing doctors, nurses, hospitals, patients and senior citizens — opposes the bill.
Unable to win a debate on its merits, Republican leaders need to change the subject. They can’t let their proposals be judged on whether they improve the American health care system, because they don’t. They need to create a lower standard by which the plan will be judged.
The House did so in the frantic week that it passed its bill by pointing to a last-minute amendment that made a superficial improvement. House members then claimed they had fixed their bill.
Senate leaders are showing signs of following the same path — and the C.B.O. report gives them a chance to start down it. The report will encourage top Republicans to claim that their bill is already getting better and that the Senate will keep improving it in coming months.
In truth, the bill is fatally flawed. Its objective is to reduce federal spending on health insurance for the middle class, poor, sick, elderly and disabled in order to cut taxes for the wealthy. Maybe the final version, once the Senate has made its tweaks, will take insurance from 23 million people, or maybe 15 million people. But any law based on the House bill is guaranteed to worsen the health care system.
That’s the overwhelming message of the C.B.O. report.
The saddest part of this situation is that our health care system, including Obamacare, very much needs improvement. And there are solid bipartisan ideas out there, including some that would increase states’ flexibility or lower consumer expenses. The Senate has members from both parties with the savvy and the policy chops — like Lamar Alexander and Patty Murray — to turn those ideas into a bill.
Is it too much to hope that they cast aside the distractions from the House’s failed plan and start fresh?
The full Opinion report from The Times follows, including Abbe Gluck on the G.O.P.’s sabotage of Obamacare.”

“WASHINGTON — A bill to dismantle the Affordable Care Act that narrowly passed the House this month would leave 14 million more people uninsured next year than under President Barack Obama’s health law — and 23 million more in 2026, the Congressional Budget Office said Wednesday. Some of the nation’s sickest would pay much more for health care.

Under the House bill, the number of uninsured would be slightly lower, but deficits would be somewhat higher, than the budget office estimated before Republican leaders made a series of changes to win enough votes for passage. Beneath the headline-grabbing numbers, those legislative tweaks would bring huge changes to the American health care system.

In many states, insurance costs could soar for consumers who are sick or have pre-existing conditions, while premiums would fall for the healthy, the new estimate concludes.

The forecast by the nonpartisan Congressional Budget Office, Capitol Hill’s official scorekeeper, is another potential blow to efforts to undo Mr. Obama’s signature domestic achievement. Republican senators have said they will make substantial changes to the measure passed by the House, but even Senator Mitch McConnell of Kentucky, the majority leader, sounds uncertain about his chances of finding a majority to repeal and replace the health law.”

**********************************************

Read Robert’s complete article at the link. Decades ago, when we were both young, Robert covered the “immigration beat” for the NYT. In the days before Administrations of both parties went to war with the press, he used to call me on a regular basis to get the “official INS position” on various controversies, particularly those involving legal issues.

“While the rest of the country has been transfixed by Trumpian chaos, members of the Senate have spent the last two weeks talking about taking health insurance from millions of Americans.

There is an alarmingly large chance that they’ll decide to do so. But if they do, they will almost certainly rely on a political sleight of hand to disguise their bill’s damage. Understanding that sleight of hand — and calling attention to it — offers the best hope for defeating the bill.

The effort to take health insurance from the middle class and poor and funnel the savings into tax cuts for the rich is a little like mold. It grows best in the dark.

That’s why Republican leaders in the House handled their bill as they did. They did not hold a single hearing, because they knew that attention would have been devastating.

Just imagine a hearing featuring the leaders of these groups, every one of which opposes the House bill: the American Medical Association, American Nurses Association, American Hospital Association, American Academy of Pediatrics, American Cancer Society, American Heart Association, American Diabetes Association, American Lung Association, March of Dimes and AARP.
The House also passed its final bill without waiting for the Congressional Budget Office to estimate how many Americans would lose insurance. The C.B.O. will release that analysis tomorrow afternoon. There is no precedent, outside of wartime, for passing a bill this important in such haste.

After the House did, many observers assumed the bill was too flawed to have much chance in the Senate. Republican senators, aware of the bill’s unpopularity, were careful to say publicly that they would start fresh. But the early signs suggest that Mitch McConnell and his Republican caucus are actually mimicking the House approach.

Think of it as the Upton strategy, and I’ll explain the name in a minute.”

************************************************

Yet, the voters keep putting these guys in office. Unless you are part of the tiny percentage of over-privileged, rich elite in America, you’re voting against not only our country’s best interests, but your own!

Amazingly, however, the Democrats have failed to come up with an effective strategy to capitalize on this. And, to date, I’m not sure I’ve heard any compelling arguments as to how and why Democrats will do better in the next election.

Yeah, Trump and his cohorts have problems galore. But, highlighting/relying on that was Hillary’s primary strategy in 2016. And, it failed! Big time! What positive plan do Democrats have for making America better for everyone (including most Trump supporters)?